Ask The Expert is a new column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.
This week, Registered Dietitian Milton Stokes offers his thoughts on a common concern of many parents who worry that their child is not eating enough.
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Milton Stokes, MPH, RD
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Question: My child is underweight. How can I get him to eat more?
Answer:
Underweight could be related to medical problems or just to a restricted diet. Either way, I make sure each pediatric patient’s growth is charted on a growth chart. We need to monitor trends and patterns. Sometimes underweight really isn’t a problem; trending positively in the right direction matters more. Provided there are no medical abnormalities, then we can quite simply address diet.
What parent hasn’t experienced concern and frustration when a toddler doesn’t eat what we think they should eat. But take note: A little one’s ability to regulate dietary intake is in fact as close to perfection as it’ll ever be for his entire life. Yes! They may not finish everything on their plate or eat their cruciferous veggies. This is normal. Children are true experts at regulating their intakes: one meal might be scant; another quite large. The result is ideal balance. Overall intake is what matters most. It’s not until well-intentioned adults (i.e., grandparents?) who interject insisting a child clean his plate that problems arise. This teaches the child to override his inherent ability to regulate dietary intake. In my practice, I insist families eliminate membership in the Clean Plate Club. Eat when hungry; stop when full.
Another consideration for a child’s eating pattern is that introducing new, unfamiliar foods takes time and patience. Research and my professional experience confirms that what a parent does—role modeling during meals—is the most important way to encourage healthful eating. Avoid food fights and food struggles. Gentle episodes of exposure to new foods—as many as ten or more separate occasions—may be required to successfully expand a child’s intake.
Happy eating!
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Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

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{ 4 comments… read them below or add one }
My Question is: If you had to pick three super healthy foods for a 12 month old to eat, what would they be? My daughter is a picky eater. She will eventually eat foods after they are presented to her about 20 times. Which 3 foods should I focus on right now? She has primarily been breastfed up until this point. I have cut back on pumping during the day (she is receiving about 6 ounces of breastmilk). Her other fluid intake is water. Then I nurse on demand in the evenings and at night.
Nothing beats breastfeeding. So good for you and your baby! Weaning may take place during the 6 – 12 month range.
For the one-year mark, it’s time for solids. At this point your child should eat during normal meal times and eat with the family where the family eats. Texture should be soft, chopped and/or easily gummed depending upon dentition. Avoid making separate, special meals just for your child. Some variation of the family’s meal is preferred. In other words, don’t create a routine of being a short-order cook.
An introduction of up to 20 times may seem excessive, but it’s not. As I said before, what a parent eats–how she models food consumption–is far superior to anything else. I discourage emphasizing certain foods as “good” or “bad,” or using food for any purpose other than nourishment. (For example, refrain from rewarding with food.)
Now, to actually answer your question: nothing is more “super” than fruits and veggies and whole grains. You may need to present them differently and call them different names. Instead of apples, call them “apple smiles” or “smiley fruit.” Or you could cook the apple in the microwave and fill the center with oats, a little brown sugar, and a sprinkle of cinnamon. Call it the “apple cave.” Additionally, you can slice bananas and call them “wheels” or “flying saucers.” Another common one is “trees” for broccoli. (Cook and/or chop tough foods to prevent choking.)
Do you have a garden. Let your daughter help you. “Help” may mean play in the dirt, but at least it’s some exposure. Little by little her diet will change/improve. Just note: her stomach only holds a tiny bit of food compared to an adult’s, so you don’t have to worry if she only eats a couple cooked carrot sticks.
Thanks for this answer!
How about recommending a health drink with all nutrition elements for fussy eaters (toddlers).